KENNEDY STIDHAM (NPI# 1811597545) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811597545 |
| Entity Type | Individual |
| Full Name | KENNEDY STIDHAM |
| Credential | RBT |
| Practice Address |
555 William D Fitch Pkwy College Station TX 77845-6141 |
| Practice Telephone | 9793140474 |
| Enumeration Date | 2020-10-30 |
| Last Update Date | 2020-11-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| Street Address |
555 WILLIAM D FITCH PKWY |
| City | COLLEGE STATION |
| State | TX |
| Zip Code | 77845-6141 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902332737 | Shatoya Eshelle Gilliam | Behavior Technician | 555 William D Fitch Pkwy, College Station, TX 77845-6141 | 2017-05-11 |
| 1770109431 | Mary Grace Dekeratry | Behavior Technician | 555 William D Fitch Pkwy, College Station, TX 77845-6141 | 2020-06-18 |
| 1821610767 | Liana Molino | Behavior Technician | 555 William D Fitch Pkwy, College Station, TX 77845-6141 | 2020-05-14 |
| 1295369866 | Alma Garza | Behavior Technician | 555 William D Fitch Pkwy, College Station, TX 77845-6141 | 2020-02-23 |
| 1720610991 | Gabrielle Marissa Hojnacki | Behavior Technician | 555 William D Fitch Pkwy, College Station, TX 77845-6141 | 2020-02-06 |
| 1760021323 | Ashleigh Sheppard | Behavior Technician | 555 William D Fitch Pkwy, College Station, TX 77845-6141 | 2019-12-31 |
| 1184182172 | Hope Danielle Townsend | Behavior Technician | 555 William D Fitch Pkwy, College Station, TX 77845-6141 | 2019-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518503101 | Aggieland Urgent Care Pllc | Clinic/Center | 13055 Fm 2154 Rd, College Station, TX 77845 | 2019-11-19 |
| 1770053399 | Alyssa Nicole Sanchez | Licensed Vocational Nurse | 4030 Hwy 6 S 150, College Station, TX 77845 | 2018-11-27 |
| 1154805778 | Medical Care Innovation, P.C. | Clinic/Center | 200 Quality Circle, College Station, TX 77845 | 2018-09-19 |
| 1003302530 | Kaye Lynn Tseng | Registered Nurse | 4030 Hightway 6 South, College Station, TX 77845 | 2018-07-09 |
| 1083117907 | College Station Dentistry and Orthodontics Pllc | Dentist | 11671 Fm 2154, Suite 400, College Station, TX 77845 | 2018-03-16 |
| 1912409954 | H-e-b, Lp | Clinical Medical Laboratory | 11675 Fm 2154, College Station, TX 77845 | 2018-03-06 |
| 1871095745 | Gregory Nicholas Perry | Physical Therapist | 4091 Sh 6 South, Suite B, College Station, TX 77845 | 2018-03-06 |
| 1811435639 | Michael Patke | Student in an Organized Health Care Education/Training Program | 10613 Deer Run Dr., College Station, TX 77845 | 2017-02-01 |
| 1558810473 | Sara Beth Williamson | Nurse Practitioner | 4401 State Hwy 6 S, College Station, TX 77845 | 2016-10-04 |
| 1881067379 | Kieshia Lewis | Occupational Therapy Assistant | 2700 Earl Rudder Frwy Suite 1200, College Station, TX 77845 | 2015-11-05 |
| Find all providers in zip 77845 | ||||
| Taxonomy Code | 106S00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavior Technician |
| The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work. |
| Notes: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285197897 | Cayley Huggins | Behavior Technician | 700 University Dr E, College Station, TX 77840-5807 | 2019-04-10 |
| 1902332737 | Shatoya Eshelle Gilliam | Behavior Technician | 555 William D Fitch Pkwy, College Station, TX 77845-6141 | 2017-05-11 |
| 1174122675 | Payton Hagan | Behavior Technician | 700 University Dr E Ste 106, College Station, TX 77840-1848 | 2020-10-26 |
| 1245845080 | Myra Vanessa Grijalva | Behavior Technician | 700 University Dr E Ste 106, College Station, TX 77840-1848 | 2020-09-09 |
| 1033721196 | Allyson Koger | Behavior Technician | 700 University Dr E Ste 106, College Station, TX 77840-1848 | 2020-08-20 |
| 1376152769 | Alyssa Renee Diaz | Behavior Technician | 700 University Dr E, College Station, TX 77840-5807 | 2020-07-30 |
| 1720696594 | Charlice Perry | Behavior Technician | 700 University Dr E Ste 106, College Station, TX 77840-1848 | 2020-07-17 |
| 1639787526 | Tamra White | Behavior Technician | 700 University Dr E Ste 106, College Station, TX 77840-1848 | 2020-07-16 |
| 1609493857 | Maegan Nicole Sosebee | Behavior Technician | 700 University Dr E, College Station, TX 77840-5807 | 2020-07-02 |
| 1801413232 | Kelsea Brantley | Behavior Technician | 700 University Dr E Ste 106, College Station, TX 77840-1848 | 2020-07-01 |
| Find all providers in COLLEGE STATION | ||||
| City | COLLEGE STATION |
| Zip Code | 77845 |
Please comment or provide details below to improve the information on KENNEDY STIDHAM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.